The Centers for Medicare & Medicaid Services (CMS) released new guidance this week on Medicare payment for telehealth services following the CY 2026 Medicare Physician Fee Schedule Final Rule [refer to Washington Highlights, Nov. 7] and telehealth flexibility extensions through Jan. 30, 2026 [refer to Washington Highlights, Nov. 14].
The CMS released a new set of telehealth FAQs (PDF) on Nov. 20 (dated Nov. 14) where the agency addressed concerns raised by the AAMC and other stakeholders [refer to Washington Highlights, Sep. 12], including details on when clinicians may provide telehealth services from home. Notably, the CMS stated “Practitioners who furnish telehealth services from their homes but have a physical practice location are not required to report their home address on their Medicare enrollment application. ... Virtual-only telehealth practitioners whose only physical practice location is their home address will need to enroll their home address as a practice location.”
The CMS, Nov. 21, updated the Processing of Telehealth and Acute Hospital Care at Home Claims and instructions for Medicare administrative contractors to return a subset of previously held telehealth claims submitted on or before Nov. 10. Specifically, the CMS instructed clinicians to resubmit returned or previously denied claims and submit any telehealth claims that were held in anticipation of possible congressional action, and that it rescinds Nov. 6 instructions to use new modifiers on certain telehealth claims. The agency also encouraged clinicians to identify patients who were charged for telehealth services with dates of service on or after Oct. 1 that are retroactively payable and instead submit applicable claims while refunding any overpayment to beneficiaries. Hospitals may resubmit claims for the Acute Hospital Care at Home initiative for dates of service on or after Oct. 1, and that facilities and clinicians should observe a return to normal processing operations over the coming days.